药物循环使用对细菌耐药监测管理的效果分析

Analysis of the effects of drug recycling on bacterial resistance monitoring and management

目的分析阿莫西林/克拉维酸钾、哌拉西林/他唑巴坦、头孢噻肟三种抗菌药物循环使用对目标细菌肺炎克雷伯菌和大肠埃希菌及对以上三种耐药率监测的效果。方法在抗菌药物合理使用前提下,通过行政干预人为模拟抗菌药物循环使用环境,以6个月为1个周期,交替循环使用阿莫西林/克拉维酸钾、哌拉西林/他唑巴坦、头孢噻肟三种抗菌药物;并以肺炎克雷伯菌和大肠埃希菌为监测目标,对比分析每周期细菌耐药监测数据。结果阿莫西林/克拉维酸钾单独使用6个月后,肺炎克雷伯菌和大肠埃希菌对其耐药率略有增加,而对于哌拉西林/他唑巴坦和头孢噻肟的耐药率明显下降,差异有统计学意义(P<0.05);在使用哌拉西林/他唑巴坦周期内,肺炎克雷伯菌和大肠埃希菌对其耐药率有所增加,而对于阿莫西林/克拉维酸钾和头孢噻肟的耐药率明显下降,差异有统计学意义(P<0.05);在使用头孢噻肟周期内,肺炎克雷伯菌和大肠埃希菌对其耐药率有增加,但对于阿莫西林/克拉维酸钾和哌拉西林/他唑巴坦的耐药率明显下降,差异有统计学意义(P<0.05)。结论抗菌药物循环使用在一定范围内可减低病原微生物的耐药率,在医院细菌耐药监测管理中有实际应用价值。

Objective To analyze the monitoring effects of recycling use of amoxicillin/clavulanate potassium, piperacillin/tazobaetam and cefotaxime on the resistance rate of the target bacteria of Klebsiella pneumoniae and Es- eherichia coli to the above three antimierobial agents. Methods With the rational use of antimicrobial agents, three an- timicrobial drugs of amoxicillin/elavulanate potassium, piperaeillin/tazobactam, and cephalosporin were in recycling use with 6 months as a cycle through administrative intervention and artificial stimulation of antimierobial drugs recycling use environment; Klebsiella pneumoniae and Escherichia coli were selected as the monitoring objectives, and bacterial resistance monitoring data in each cycle were compared and analyzed. Results The resistance rate of Klebsiella pneu- moniae and Eseheriehia coli to amoxieillin/clavulanate potassium alone was increased slightly after 6 months. However, the drug resistance rate to piperacillin/tazobactam and cefotaxime was significantly decreased, the difference was statis- tically significant（P〈0.05）. In the piperaeillin/tazobaetam cycle, the drug resistance rate of Klebsiella pneumoniae and Escherichia coli to them was increased, while resistance rate to amoxieillin/elavulanate potassium and eefotaxime was significantly decreased, the difference was statistically significant（P〈0.05）. In the cefotaxime cycle, the resistance rate of Klebsiella pneumoniae and Escheriehia coli was increased, but the resistance rate to amoxieillin/clavulanate potassium and piperacillin/tazobactam was significantly decreased, the difference was statistically significant（P〈0.05）. Conclusion The recycled use of antimicrobial agents within a certain range can reduce the resistance rate of pathogenic microor- ganisms, which has a practicaI value in the monitoring and management of bacterial resistance in the hospital.